Machine learning algorithms predict experimental output of chaotic lasers.

We apply an artificial neural network (ANN) of 20 hidden layers and backpropagation regression to the forecast of experimental time series from a Kerr lens mode locking (KLM) Ti:sapphire laser and a Nd:vanadate with modulation losses. In both cases the neural network is able to predict up to 10 steps ahead. In the Ti:sapphire laser the prediction in pulse amplitude is accurate even when the pulse is an extreme event. In the Nd:vanadate laser we forecast both pulse amplitude and pulse-to-pulse time separation. In both cases the prediction goes beyond the Lyapunov prediction horizon.

The paralytic shellfish toxin effect on bioenergetic constituents of the fishery resource Chorus giganteus (Gastropoda: Muricidae).

Alexandrium catenella, one of the most common harmful microalgae observed in southern Chile, produces paralytic shellfish toxins, which can affect many organisms throughout the trophic chain. This research evaluated how paralytic shellfish toxins affected the principal bioenergetic constituents and fatty acids composition of the carnivorous snail Chorus giganteus. Snails were separated into a "toxic" group that was fed the toxic clam Mulinia edulis (which was previously fed A. catenella), and a "non-toxic" group, fed non-toxic clams. Both groups were kept under these conditions for 63 days. Our results indicated no difference in the ingestion rate of toxic versus non-toxic snails; however, a higher protein level was identified in toxic snails. The total lipid content proved to be no different in toxic versus non-toxic snails; although, an effect of the toxic diet on the fatty acid profile of C. giganteus was observed. High levels of essential polyunsaturated fatty acids, especially docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) in toxic snails, were identified. Our results suggest that exposure to paralytic shellfish toxins, through diet, may cause changes in the biochemical composition of C. giganteus, which may have a subsequent impact on its energetic physiology.

Updated recommendations of the International Dengue Initiative expert group for CYD-TDV vaccine implementation in Latin America.

Dengue disease represents a large and growing global threat to public health, causing a significant burden to health systems of endemic countries. For countries considering vaccination as part of their Integrated Management Strategy for Prevention and Control of Dengue, the World Health Organization currently recommends the first licensed dengue vaccine, CYD-TDV for: individuals aged 9 years or above from populations with high transmission rates, based on either seroprevalence criteria or pre-vaccination screening strategies, and for persons with confirmed prior exposure to infection in moderate to lower transmission settings. This paper describes the main conclusions of the Sixth Meeting of the International Dengue Initiative (IDI) held in June 2018, following release of a new product label by the manufacturer, updated WHO-SAGE recommendations, additional scientific evidence on vaccine performance, and reports of experiences by implementing countries. Considerations were made regarding the need for improving the quality of epidemiological and surveillance data in the region to help define the convenience of either of the two vaccination strategies recommended by WHO-SAGE. Extensive discussion was dedicated to the pros and cons of implementing either of such strategies in Latin America. Although, in general, a seroprevalence-based approach was preferred in high transmission settings, when cost-effectivity is favorable pre-vaccination screening is a convenient alternative. Cost-effectiveness evaluations can assist with the decisions by public health authorities of whether to introduce a vaccine. Where implemented, vaccine introduction should be part of a public health strategy that includes the participation of multiple sectors of society, incorporating input from scientific societies, ministries of heath, and civil society, while ensuring a robust communication program.

Monitoring of the novel rabbit haemorrhagic disease virus type 2 (GI.2) epidemic in European wild rabbits (Oryctolagus cuniculus) in southern Spain, 2013-2017.

Rabbit hemorrhagic disease (RHD) is a highly infectious disease in European rabbits (Oryctolagus cuniculus), caused by a virus belonging to the genus Lagovirus (RHDV; family Caliciviridae). In 2010, a new genotype of RHDV (RHDV2 or RHDVb, currently designated GI.2) emerged in France, affecting both domestic rabbits, even those vaccinated for the classical RHDV genotypes (currently designated GI.1) and wild rabbits. GI.2 was subsequently identified in other European countries. The aim of the present study was to monitor the GI.2 epidemic in wild rabbits in Andalusia (southern Spain) during the period 2013-2017. At the beginning of summer 2013, high mortalities were detected in wild rabbit populations in southern Spain. A total of 96 affected hunting or protected areas were surveyed. The first outbreak was observed on June 2013. The number of outbreaks sharply increased in 2013 and 2014, with a decreasing trend being observed during the following years. The spatial distribution of GI.2 was not homogeneous, since most of the detected outbreaks were concentrated in the western part of Andalusia. The outbreaks peaked in winter and spring and have been detected in the last five consecutive years, which suggests endemic circulation of GI.2 in wild rabbit populations in Spain. A total of 190 dead rabbits from 87 of the 96 areas surveyed were collected during the study period. Mortality affected rabbits of different age classes, including kittens. RT-PCR confirmed the presence of GI.2 RNA in the livers of 185 of the 190 (97.4%) rabbits. Phylogenetic analysis performed on eleven samples collected in different provinces of Andalusia between 2013 and 2017, showed high nucleotide identity with GI.2 strains Spain, France and Portugal. The results constitute an important step in understanding of the emergence and spread of GI.2 in this country and will provide valuable information for the development of surveillance programs in Europe.

Acromegalia y cáncer de tiroides

RESUMEN: Introducción La acromegalia se asocia con un mayor riesgo de morbilidad y mortalidad por cáncer. Sin embargo, los datos respecto de la incidencia de cáncer en acromegalia son controvertidos. Objetivos Describir las características clínicas, bioquímicas e imagenológicas de un grupo de pacientes acromegálicos con carcinoma diferenciado de tiroides (CDT). Analizar las características de riesgo de recurrencia (RR) y respuesta en el seguimiento (RtaSg) y comparar la evolución con la de pacientes con CDT no acromegálicos. Materiales y métodos Se realizó un análisis retrospectivo multicéntrico de pacientes con diagnóstico de acromegalia y CDT. Se realizó un análisis comparativo entre los pacientes de bajo RR inicial acromegálicos con una muestra aleatoria de pacientes no acromegálicos con CDT de bajo RR inicial (1:4). Resultados Se analizaron 16 pacientes con diagnóstico de CDT y acromegalia. En 93,8% se hizo el diagnóstico por ecografía, sólo el 50% tenían un nódulo tiroideo palpable. En el momento del diagnóstico del CDT, los valores de IGF-1 fueron 1,8 ± 1,3 LSN, con 62,5% con acromegalia activa. La histología fue papilar en todos los casos, el 56,3% variedad clásica y el resto papilar variedad folicular. El 75% de los pacientes presentó un Estadio I (12/16), sólo 3 pacientes Estadio II y 1 Estadio IVb. El RR inicial fue bajo en el 87,6% (14/16), intermedio en 1 paciente y alto en 1 paciente. Las respuestas al final del seguimiento fueron: 86,7% (13/15) sin evidencia de enfermedad, 1 paciente bioquímica incompleta y 1 estructural incompleta. La RtaSg no tuvo diferencias con los no acromegálicos. Conclusiones Los pacientes acromegálicos con CDT presentaron predominantemente un bajo RR inicial. Al realizar la comparación con el grupo control, se puede concluir que el CDT en pacientes acromegálicos no presentó una evolución más agresiva.

A randomized control trial of the impact of LCPUFA-ω3 supplementation on body weight and insulin resistance in pubertal children with obesity.

BACKGROUND: Paediatric obesity and insulin resistance (IR) are potentially reversible inflammatory conditions. Long chain polyunsaturated fatty acids omega-3 (LCPUFA-ω3) show anti-inflammatory and metabolic properties, but their clinical efficacy is unclear. OBJECTIVE: The objective of this study is to evaluate whether supplementation with LCPUFA-ω3 for 3 months reduces insulin resistance and weight to adolescents with obesity. METHODS: Double-blind trial of 366 adolescents with obesity randomly assigned to 1.2-g LCPUFA-ω3 (DO3) or 1-g sunflower oil (DP) daily for 3 months; both groups received an energy-restricted diet. Children attended monthly for anthropometric, dietary, and clinical measurements. Basal and final blood samples were obtained to measure metabolic markers and erythrocytes fatty acids. Regression models were used for analysis. RESULTS: A total of 119 DO3 and 126 DP children completed follow-up. At baseline, 92% of children presented IR, 66% hypertriglyceridemia, 37% low-grade inflammation, and 32% metabolic syndrome. Despite erythrocytes LCPUFA-ω3 increased more in DO3 (Median differences = 0.984 w/w%; 95 IC = 0.47, 1.53, P < 0.001), body weight, insulin, and HOMA changed similarly in both groups at the end of intervention. Adjusting for basal values, changes in weight, insulin, and HOMA was not related with supplementation. CONCLUSIONS: Supplementation with LCPUFA-ω3 does not affect body weight or insulin in adolescents with obesity.

Development of a Novel Reverse Transcription Loop-Mediated Isothermal Amplification Assay for the Rapid Detection of African Horse Sickness Virus.

African horse sickness (AHS) is a disease of equids caused by African Horse Sickness Virus (AHSV) and is transmitted by Culicoides midges. AHS is endemic in sub-Saharan Africa, but during the past century, outbreaks of significant economic importance and elevated mortality have been recorded in Northern African countries, the Iberian and Arabian Peninsula, the Middle East and the Indian subcontinent. Effective control combines the application of early warning systems, accurate laboratory diagnosis and reporting, animal movement restrictions, suitable vaccination and surveillance programs, and the coordination of all these measures by efficient veterinary services. Conventional reverse-transcriptase (RT) PCR (RT-PCR) and real-time RT-PCR (rRT-PCR) assays have improved the sensitivity and rapidity of diagnosing AHS, resulting in the adoption of these methods as recommended tests by the World Organisation for Animal Health (OIE). However, currently these assays are only performed within laboratory settings; therefore, the development of field diagnostics for AHS would improve the fast implementation of control policies. Loop-mediated isothermal amplification (LAMP) is an isothermal, autocycling, strand-displacement nucleic acid amplification technique which can be performed in the field. LAMP assays are attractive molecular assays because they are simple to use, rapid, portable and have sensitivity and specificity within the range of rRT-PCR. This study describes the development of a novel RT-LAMP assay for the detection of AHSV. The AHSV RT-LAMP assay has an analytical sensitivity of 96.1% when considering an rRT-PCR cut-off value of CT  > 36, or 91.3% when no rRT-PCR cut-off is applied. Diagnostic sensitivity and specificity were 100%. This assay provides for a rapid and low cost AHS diagnostic for use in the field.

Protocolo de seguimiento de los pacientes con displasia broncopulmonar / Guidelines for the follow up of patients with bronchopulmonary dysplasia

La displasia broncopulmonar (DBP) es la secuela más prevalente del recién nacido pretérmino, y sigue suponiendo un motivo frecuente de consulta en las unidades de Neumología Pediátrica. La decisión del alta de la unidad neonatal debe apoyarse en una valoración exhaustiva de la situación clínica del paciente y en el cumplimiento de unos requisitos, que incluyen la estabilidad respiratoria y nutricional, y la instrucción a los cuidadores en el manejo domiciliario. Para un control adecuado de la enfermedad, es necesario que quede establecido, previamente al alta, un calendario de visitas y de exploraciones complementarias, y deben aplicarse las pautas de prevención de exacerbaciones y el tratamiento apropiados. El concepto de DBP como enfermedad multisistémica es fundamental en el seguimiento de los pacientes y debe ser tenido en cuenta para un buen control de la enfermedad. En este documento, el Grupo de Trabajo de Patología Respiratoria Perinatal de la Sociedad Española de Neumología Pediátrica propone un protocolo que sirva como referencia para unificar el seguimiento de los pacientes con DBP entre los diferentes centros y ámbitos asistenciales. Se revisan los aspectos a tener en cuenta en la evaluación previa al alta de la Unidad Neonatal y las principales complicaciones durante el seguimiento. Seguidamente, se detallan las recomendaciones en materia de tratamiento de la enfermedad y prevención de complicaciones, los controles tras el alta y su cronología

Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth, and remains a major problem in pediatric pulmonology units. The decision of discharging from the Neonatal Unit should be based on a thorough assessment of the condition of the patient and compliance with certain requirements, including respiratory and nutritional stability, and caregiver education on disease management. For proper control of the disease, a schedule of visits and complementary tests should be established prior to discharge, and guidelines for prevention of exacerbations and appropriate treatment should be applied. In this paper, the Working Group in Perinatal Respiratory Diseases of the Spanish Society of Pediatric Pulmonology proposes a protocol to serve as a reference for the follow up of patients with BPD among different centers and health care settings. Key factors to consider when planning discharge from the Neonatal Unit and during follow up are reviewed. Recommendations on treatment and prevention of complications are then discussed. The final section of this guide aims to provide a specific schedule for follow-up and diagnostic interventions to be performed in patients with BPD

[Guidelines for the follow up of patients with bronchopulmonary dysplasia]. / Protocolo de seguimiento de los pacientes con displasia broncopulmonar.

Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth, and remains a major problem in pediatric pulmonology units. The decision of discharging from the Neonatal Unit should be based on a thorough assessment of the condition of the patient and compliance with certain requirements, including respiratory and nutritional stability, and caregiver education on disease management. For proper control of the disease, a schedule of visits and complementary tests should be established prior to discharge, and guidelines for prevention of exacerbations and appropriate treatment should be applied. In this paper, the Working Group in Perinatal Respiratory Diseases of the Spanish Society of Pediatric Pulmonology proposes a protocol to serve as a reference for the follow up of patients with BPD among different centers and health care settings. Key factors to consider when planning discharge from the Neonatal Unit and during follow up are reviewed. Recommendations on treatment and prevention of complications are then discussed. The final section of this guide aims to provide a specific schedule for follow-up and diagnostic interventions to be performed in patients with BPD.

Stomach nematodes of three sympatric species of anatid birds off the coast of Patagonia.

The present study focuses on the nematode community in the stomachs of three sympatric anatid bird species from the Central Patagonian coast, Argentina. The bird species include the Chubut steamer duck, Tachyeres leucocephalus, the crested duck, Lophonetta specularioides, and the black-necked swan, Cygnus melancoryphus. Up to 138 nematodes representing five species were recovered from 10 of the 13 ducks examined, with an overall prevalence of 77% and a mean intensity of 13.8. Nematodes isolated from the gizzard were Streptocara formosensis and Sciadiocara legendrei (Acuariidae) in T. leucocephalus, and Epomidiostomum vogelsangi (Amidostomatidae) in C. melancoryphus, whereas Echinuria uncinata (Acuariidae) and Tetrameres (Petrowimeres) fissispina (Tetrameriidae) were found in the proventiculus of L. specularioides. In particular, S. legendrei was registered for the first time in South America and T. leucocephalus, whereas T. fissispina represents a new record in Argentina and L. specularioides. Moreover, E. vogelsangi and E. uncinata were isolated in Patagonia for the first time. The birds studied herein are sympatric in their distribution, and two of them are syntopic breeders; however, they were infected with different parasite species. This situation could be partially due to their diet or their seasonal movements, or a combination of both. Despite the low number of hosts examined, this work enhances our knowledge about parasites from a frequently occurring group of birds on the Patagonian coast, a subject that has not been studied extensively in South America.

Statistical optimization of a novel low-cost medium based on regional agro-industrial by-products for the production of proteolytic enzymes by Bacillus cereus.

Bacillus sp. are specific producers of peptidase amongst bacteria and peptidase enzymes and are of significant ones due to their multifarious applications. Advances in industrial biotechnology offer potential opportunities for economic utilization of agro-industrial by-products for many biochemical reactions. Due to their rich organic nature, they can serve as an ideal substrate for the production of different value added products like peptidases. In the present work, an attempt was made to optimize different variables by Taguchi methodology for the production of peptidase using agro-industrial by-products hydrolyzed by a Bacillus cereus strain, resulting in brewer's spent grain (BSG) being the optimal organic substrate. Subsequently, operative variables for the BSG were investigated using Taguchi methodology in order to maximize the enzyme production. Additionally, the main medium components were optimized using a mixture design. Finally, the production of peptidase by B. cereus was investigated; also the possible interaction with other proteolytic microbial strains was evaluated. A notorious synergistic effect was observed when B. cereus was inoculated with Pseudomonas sp. These brought a triple benefit, first, opening the possibility to produce technical enzymes at low cost, second, giving greater value to a food industry by-product, and third, reducing the environmental impact caused by the product removal directly into the environment.

Protocolo de diagnóstico y seguimiento de los pacientes con fibrosis quística / Protocol for the diagnosis and follow up of patients with cystic fibrosis

La fibrosis quística (FQ) es la enfermedad autosómica recesiva grave más frecuente de la raza caucásica. El aumento tan importante de la supervivencia de los pacientes con FQ en los últimos años se debe en gran parte a la disponibilidad de nuevos tratamientos de la enfermedad pulmonar, en especial de las infecciones respiratorias. Este protocolo revisa y actualiza los aspectos del diagnóstico y el manejo de la enfermedad respiratoria de la FQ. La prueba del sudor continúa siendo el estándar del diagnóstico de la FQ aunque, pese a realizarse de la forma adecuada, no siempre es concluyente. Se debe controlar a los pacientes con FQ en unidades especializadas por un equipo multidisciplinario y experto, mediante protocolos específicos de seguimiento clínico, estudios por imagen y pruebas funcionales respiratorias y microbiológicas que se actualizan en esta revisión. Se incluyen las recomendaciones sobre el tratamiento precoz y agresivo de la primoinfección y de la infección crónica por Pseudomonas aeruginosa, Staphylococcus aureus y otros microorganismos no habituales. Asimismo se describen los tratamientos de los diferentes aspectos de la enfermedad pulmonar y sus complicaciones y se revisan las indicaciones y el estado actual del trasplante pulmonar. Este documento de consenso ha sido elaborado por los miembros del Grupo de Trabajo de Fibrosis Quística de la Sociedad Española de Neumología Pediátrica con el objetivo de actualizar el previo, publicado en esta Revista en 1999 (AU)

Cystic fibrosis (CF) is the most common severe recessive genetic disease in Caucasians. During the last years, new therapies and aggressive management of the lung disease have contributed significantly to the increased life expectancy in CF patients. A review and update of CF diagnosis and management of lung disease are included. The sweat chloride test (SCT) remains the gold standard for CF diagnosis and should be performed properly. However, in a few patients SCT results may not be conclusive to clarify the CF diagnosis. Patients with CF should be followed up in specialist Units by an expert multidisciplinary expert applying standard clinical protocols and using lung function tests, and microbiological and imaging studies. An overview with the recommendations for treatment of early onset and chronic infections due to Pseudomonas aeruginosa, Staphylococcus aureus and other uncommon pathogens is included. Furthermore, the management of other aspects of CF lung disease and complications is provided, as well as the indications for lung transplantation. This document has been prepared by the members of the CF working group of the Spanish Paediatrics Pulmonary Society to provide an update to the earlier documents published in this Journal in 1999 (AU)

[Protocol for the diagnosis and follow up of patients with cystic fibrosis]. / Protocolo de diagnóstico y seguimiento de los pacientes con fibrosis quística.

Cystic fibrosis (CF) is the most common severe recessive genetic disease in Caucasians. During the last years, new therapies and aggressive management of the lung disease have contributed significantly to the increased life expectancy in CF patients. A review and update of CF diagnosis and management of lung disease are included. The sweat chloride test (SCT) remains the gold standard for CF diagnosis and should be performed properly. However, in a few patients SCT results may not be conclusive to clarify the CF diagnosis. Patients with CF should be followed up in specialist Units by an expert multidisciplinary expert applying standard clinical protocols and using lung function tests, and microbiological and imaging studies. An overview with the recommendations for treatment of early onset and chronic infections due to Pseudomonas aeruginosa, Staphylococcus aureus and other uncommon pathogens is included. Furthermore, the management of other aspects of CF lung disease and complications is provided, as well as the indications for lung transplantation. This document has been prepared by the members of the CF working group of the Spanish Paediatrics Pulmonary Society to provide an update to the earlier documents published in this Journal in 1999.

Fundamentos de la oxigenoterapia en situaciones agudas y crónicas: indicaciones, métodos, controles y seguimiento / Oxygen therapy in acute and chronic conditions: Indications, oxygen systems, assessement and follow-up

La oxigenoterapia es una herramienta fundamental para el tratamiento de la insuficiencia respiratoria, tanto aguda como crónica. Los objetivos principales que llevan a su empleo son tratar o prevenir la hipoxemia, tratar la hipertensión pulmonar y reducir el trabajo respiratorio y miocárdico. En situaciones agudas, su utilidad está ampliamente aceptada y en situaciones crónicas se ha extendido de forma importante. Sin embargo, sigue sin haber consenso en puntos fundamentales y son pocos los aspectos en los que la actuación entre los diferentes centros esté estandarizada. El Grupo de Trabajo de Técnicas de la Sociedad Española de Neumología Pediátrica acordó elaborar unas recomendaciones avaladas por esta Sociedad sobre el empleo de este tratamiento, e incorporó las diferentes formas de actuación recogidas en revisiones recientes para intentar establecer sus indicaciones, disminuir los efectos colaterales y procurar una correcta adecuación del gasto económico. Se han incluido aspectos generales del tratamiento con oxígeno, como los mecanismos fisiológicos, las indicaciones para su empleo, tanto en situaciones agudas como crónicas, y los medios disponibles para su correcta administración. Se aborda asimismo el tratamiento del paciente con oxigenoterapia en domicilio y las situaciones especiales que pueden producirse (AU)

Oxygen therapy has become a major tool for infants with acute and chronic respiratory failure. Appropriate goals when prescribing supplemental oxygen are reduction and prevention of hypoxemia, prevention and treatment of pulmonary hypertension and decrease in respiratory and cardiac overload. This is commonplace in the acute setting and is also becoming widespread in chronic pathologies. However, there is a lack of consensus on many fundamental issues, such as appropriate indications, desirable targets and outcome measures amongst centres, reflecting a variety of clinical practices. The Techniques Group of the Spanish Society of Pediatric Pneumology undertook to design recommendations for a rational approach to oxygen therapy, reviewing the existing literature in order to establish its indications, benefits and potential risks as well as its cost-effectivenes. General aspects of oxygen treatment are reviewed including physiological mechanisms, indications, delivery systems and assessment methods. Management of patients on home oxygen therapy is also addressed with discussion of benefits and potential risks of supplemental oxygen use (AU)

[Oxygen therapy in acute and chronic conditions: Indications, oxygen systems, assessement and follow-up]. / Fundamentos de la oxigenoterapia en situaciones agudas y crónicas: indicaciones, métodos, controles y seguimiento.

Oxygen therapy has become a major tool for infants with acute and chronic respiratory failure. Appropriate goals when prescribing supplemental oxygen are reduction and prevention of hypoxemia, prevention and treatment of pulmonary hypertension and decrease in respiratory and cardiac overload. This is commonplace in the acute setting and is also becoming widespread in chronic pathologies. However, there is a lack of consensus on many fundamental issues, such as appropriate indications, desirable targets and outcome measures amongst centres, reflecting a variety of clinical practices. The Techniques Group of the Spanish Society of Pediatric Pneumology undertook to design recommendations for a rational approach to oxygen therapy, reviewing the existing literature in order to establish its indications, benefits and potential risks as well as its cost-effectivenes. General aspects of oxygen treatment are reviewed including physiological mechanisms, indications, delivery systems and assessment methods. Management of patients on home oxygen therapy is also addressed with discussion of benefits and potential risks of supplemental oxygen use.

Bordetella pertussis en Latinoamérica: ¿estamos reconociendo el problema? / Bordetella pertussis (Whooping Cough) in Latin America: Are we aware of the problem?

No disponible

Postharvest changes in water status and chlorophyll content of lettuce (Lactuca sativa L.) and their relationship with overall visual quality.

The purpose of this study was to evaluate water status, chlorophyll content (C), and overall visual quality (OVQ) of fresh butter lettuce (Lactuca sativa var. Lores) as well as these indexes' evolution during storage and their relationships, if any. Whole lettuce plants were stored at optimal postharvest conditions (0 to 2 degrees C and 97% to 99% relative humidity). Measured parameters during each sampling day were relative water content (RWC), water content (WC), free water (FW), bound water (BW), free water to total water ratio (FW/TW), C, and OVQ. All parameters were evaluated in the external, middle, and internal zones of lettuce heads. The external zone had higher initial values of RWC, WC, and FW than the internal zone. The external zone yielded the highest FW/TW ratio (85%), indicating that external leaves had more water available to be used in degradation reactions and were more perishable, with the lowest shelf life if compared with the other lettuce zones. During storage, water status index evolution differed from zone to zone. An increase in BW and a decrease in FW were detected in all lettuce zones. RWC turned out to be a more sensitive measurement than WC. Yet RWC showed no significant correlation with any index. The OVQ parameter correlates with FW directly, or indirectly through FW/TW in all lettuce zones; therefore, FW is an objective and quantitative measurement, which impacts on the visual quality of butter lettuce. The decrease in chlorophyll content observed in the external leaves strongly correlated with the decrease in OVQ.

Ataxia aguda cerebelosa posvaricela en niños costarricenses / Postvaricella cerebellar ataxia in children in Costa Rica

Introducción. La ataxia cerebelosa aguda posvaricela (ACAPV) y la meningoencefalitis son las complicaciones neurológicas agudas más comunes de la varicela. El objetivo del estudio es describir la presentación clínica, el tratamiento médico y el pronóstico de la ACAPV en niños costarricenses hospitalizados en el único hospital pediátrico de nuestro país, donde la vacunación contra la varicela aún no es sistemática. Métodos. Estudio descriptivo retrospectivo; se incluyeron pacientes de entre 1 y 12 años de edad, egresados del Hospital de Nacional Niños de Costa Rica entre enero de 1997 y junio de 2004, con el diagnóstico de ACAPV. Resultados. De los 441 pacientes inmunocompetentes que fueron hospitalizados por presentar complicaciones asociadas a virus varicela zóster durante este período, 37 pacientes (8,4 %) tuvieron ACAPV, y 24/37 (64,9 %) fueron varones. La edad media (rango) fue de 5 años (1-10 años). La media (rango) de aparición de la ataxia tras el inicio del brote fue de 2 días (1-30). El análisis del líquido cefalorraquídeo (LCR) se realizó en 22 pacientes (59,5 %) y en todos fue normal. La tomografía computarizada (TC) mostró edema cerebral en 6/18 pacientes (33,3 %). Un total 23 niños de 37 recibieron aciclovir intravenoso, aunque no se observaron diferencias significativas (p > 0,05) entre ambos grupos en cuanto a beneficio con la terapia. La duración media (rango) de la ataxia fue de 4 días (1-10) y 7 pacientes (19 %) fueron dados de alta atáxicos. La estancia hospitalaria media (rango) fue de 4,4 días (2-11). Se documentaron secuelas menores en 13/24 pacientes (54,2 %) durante las visitas de seguimiento y contactos telefónicos. Conclusiones. La ACAPV usualmente se asocia con un pronóstico favorable; sin embargo, pueden producirse secuelas neurológicas. La utilidad real del aciclovir y de realizar estudios de imágenes cerebrales en estos niños es controvertida

Introduction. Postvaricella cerebellar ataxia (PVCA) and meningoencephalitis are the most common acute neurological complications of chickenpox. The objective of this study was to describe the clinical presentation, management, and outcome of children hospitalized with PVCA in the only pediatric hospital of this developing country, where routine varicella immunization is not yet available. Methods. We performed a retrospective chart review of children aged 1-12 years old admitted to the National Children's Hospital of Costa Rica from January 1997 to June 2004 with a diagnosis of PVCA. Results. Among the 441 immunocompetent patients admitted for varicella zoster virus-associated complications during this period, 37 (8.4 %) had PVCA. Twenty-four of the 37 (64.9 %) patients were boys. The mean (range) age was 5 (1-10) years. The median (range) interval from rash onset to admission was 2 (1-3) days. Cerebrospinal fluid analysis was available in 22 (59.5 %) patients and was normal in all. Head computed tomography showed cerebral edema in six out of 18 patients (33.3 %). Intravenous acyclovir was administered to 23 patients but no significant differences in clinical manifestations or outcomes were observed in treated versus untreated patients. The mean (range) length of ataxia was 4 (1-10) days, and seven (19 %) patients were still ataxic on discharge. The mean (range) length of hospital stay was 4.4 (2-11) days. Minor sequelae were documented in 13 out of 24 (54.2 %) patients during follow-up visits and telephone contacts. Conclusions. PVCA is usually associated with a favorable prognosis; however, neurological sequelae can occur. The real utility of acyclovir treatment and brain imaging studies in these children remains controversial